Tag Archives: health policies

4 Goals for the NFL’s Medical Officer

On the cusp of the 2015 Super Bowl, NFL Commissioner Roger Goodell surprised fans with an unusual focus for his annual state of the league press conference: player safety. He announced that the league would hire a chief medical officer to oversee the league’s health policies. This is good news. But first and foremost, Goodell must firmly plant the goalposts for this new hire. What does the new top doc need to accomplish to win? Here are four goals to start:

Goal One: Make Concussions Rare

In 2014, there were 202 concussions among players in practice, preseason and regular-season games. With approximately 1,600 players, my back-of-the-envelope math calculates one concussion for every eight players — in one year alone.

The new chief medical officer will have some momentum to build on to address this issue. In recent years, the league has implemented tough restrictions about when and under what conditions players can return to the field after an injury. The league has also improved equipment and changed the rulebook to penalize hits to defenseless players. The number of concussions is down by 25% from 2013, and defenseless hits are down by 68%. The new medical officer needs to accelerate that progress.

Goal Two: Research and Enforce Best Practices

To make a major impact on players’ health and safety, the new medical officer will need to rigorously examine the protocols in place to protect players. No one can argue with the notion that, at its core, football is a contact sport; injury is inevitable. However, some injuries are entirely preventable, yet they can easily topple the career of a valuable player. In my world, we’d call this kind of injury a “Never Event” — it should never happen.

The new medical officer needs to consider how the team functions as a whole, get solid research on best practices and create enforceable guidelines for prevention. To protect past, current and future players, he or she will have to shake up the entire enterprise and institute a culture in which making the play is balanced with protecting the player.

Goal Three: Demand Safety off the Field, Too

One in eight is a frightening statistic for concussions, but, surprisingly, players may be safer on the field than in a hospital. Players — and league employees and their families — depend on the healthcare system just like the rest of us. True, players often receive treatment at elite centers of care, at the hands of celebrated physicians. But our research finds that even places with big reputations can be equally unsafe. One in six admissions to a hospital results in an adverse event, and as many as 500 people die every day from preventable errors, accidents and injuries in hospitals. Even the most highly regarded institutions struggle to keep patient safety a top priority.

But some providers are much safer than others, and the new NFL medical officer has a role to play in helping players and employees pick the winners. He or she can demand data on safety of hospitals and physician practices and use that data in decision-making. The NFL can structure health benefits packages to favor safest providers, encourage performance-based payment models and give employees transparent and candid information on quality and safety to encourage them to select the safest care. Many other employers and unions are successfully deploying these strategies, and they have good tools to help.

Goal Four: Be a Champion

Championship  isn’t exactly a standard element on boilerplate job descriptions, but it’s critical to this one. The NFL knows how to spot champions, and it should expect no less from this new hire.

The new chief medical officer needs to inspire a good number of people: teams, to change the way they function; youth, increasingly wary about the game; retired players, whose health issues cast a shadow over the whole sport; and the millions of fans who love American football.

Being a champion is the most important goal, because the NFL has the opportunity to go beyond defending its safety record and start playing offense. As a top-tier brand, the NFL could be a national leader, ensuring that safety comes first in America, on and off the field. By taking the right steps to protect players and the league, the new medical officer can inspire all the fans, not only to embrace the game, but to champion a healthier America.

This article was originally posted on Forbes.com.

Women's Health Services And The Patient Protection & Affordable Care Act

Effective August 1, 2012, federal regulators expanded the list of prevention-related services that the Patient Protection & Affordable Care Act (Affordable Care Act) requires that non-grandfathered group health plans cover in-network at no cost to covered persons to include eight more prevention-related health services for women including coverage for the mandate to cover certain contraceptive services that has engendered much debate and opposition from various religious organizations and others.

Employers and other sponsors and insurers of group health plans should review and update their health plan documents, contracts, communications and administration practices to ensure that their health plans and policies appropriately cover these and other prevention-related services that current federal regulations mandate that group health plans (other than grandfathered plans) must cover to comply with the Affordable Care Act.

Affordable Care Act Requires Non-Grandfathered Health Plans Cover Lengthy List of Prevention-Related Care With No Cost Sharing

As part of the sweeping reforms enacted by the Affordable Care Act, Congress has mandated that except for certain plans that qualify as “grandfathered,” group health plans and insurers generally must pay for 100% of the cost to cover hundreds of prevention-related health care services for individuals covered under their health plans without any co-payments or other cost-sharing.

Federal regulations have mandated since 2010 that group health plans and insurers provide in-network coverage in accordance with federal regulations implementing the Affordable Care Act’s prevention-related health services mandates for more than 800 prevention-related services listed in regulations originally published in 2009. See Agencies Release Regulations Implementing Affordable Care Act Preventive Care Mandates. The Affordable Care Act gives federal authorities the power to expand or modify this list.

Following publication of the original list, the Obama Administration engaged in lengthy discussion considerations about the scope of contraceptive and other women’s health services that would qualify as prevention related services including lengthy discussions and negotiations about mandates to provide contraceptive services viewed as highly controversial by many religious organizations and several other employers. See Affordable Care Act To Require Health Plans Cover Contraception & Other Women’s Health Procedures.

Obama Administration Adds Contraceptive & Other Women’s Health Services To Required Prevention-Related Coverage List Effective 8/1/2012

The Obama Administration moved forward on its promise to add contraceptive services and a broad list of other women’s health services to the list of prevention-related health services that employer-sponsored health plans must cover without cost to employees despite objections from religious organizations and others that the contraception mandate violates the Constitution’s freedom of religion protections.

The Obama Administration’s announcement earlier this year that it intended to move forward with plans to mandate that group health plans — including those of certain employers affiliated with religious organizations to cover contraceptive counseling and other services as prevention-related services has prompted outcry and legal challenges from a broad range of religious organizations and others. See e.g., University of Notre Dame v. Sebelius; Hercules Industries, Inc. v. Sebelius. On July 27, 2012, a Colorado District Court granted a temporary injunction barring enforcement of the contraceptive coverage mandate against a small, Catholic family-owned business challenging the mandate as a violation of the Constitutional religious freedoms of its owners. See Hercules Industries, Inc. v. Sebelius.

While these and other litigants continue to challenge the contraceptive mandates, Obama Administration officials continue to voice their commitment to standby and enforce the contraceptive and other prevention-related services mandates as implemented by current regulation. Employer and other health plan sponsors and fiduciaries that do not wish to risk exposure for violating these mandates should review and update their health plan documents, summary plan descriptions and other communications, and administrative and other procedures as necessary to comply with the applicable requirements of the regulations.